Largest OpenEMR installation?

cfapress wrote on Wednesday, December 26, 2007:

Does anyone have experience with very large OpenEMR roll-outs?

I’m trying to make this software fit in with our Organization:
15   School Based Clinics (and growing)
15   Nurses
6    Mental Health facilities
100+ Mental Health clinicians
2    Psychiatrists
12+  Secretaries

It’s an interesting struggle. Each person needs a calendar but should not be able to see certain information on certain clients. I believe we will have to make some concessions about security to make this work.

Additionally, we need to have all clients in a single database.

So far…
I’ve been able to sync our 150+ users with OpenEMR and they can log in.
I’ve made each user ‘authorized’ so they have their own calendar
I’ve imported 6000+ clients

Next up…
Import 20,000+ encounters from 2007
Sync that to people’s calendars so we can test out the calendar with real data

So, has anyone attempted such a large scale roll out of this software? I’d be interested to hear about the successes and failures that were met along the way.

Thanks,
Jason Morrill
IT Manager
Child & Family Agency

sunsetsystems wrote on Wednesday, December 26, 2007:

Why do you need all clients for multiple clinics in a single database?  I would think there are legal constraints to that.

Rod
www.sunsetsystems.com

cfapress wrote on Thursday, December 27, 2007:

One reason for having clients available across sites is that many clients visit different sites throughout the year.

For example:
A child is at School #1 for a few months, they are entered into our system
The child then moves to a different town and attends School #2.
While at School #2 we move a nurse practitioner around and that person needs access to the child’s records
Later in the year, while at School #2, the child comes into our Mental Health clinic (not in a school)

So far the child’s information has been at School #1, School #2, and Clinic #1 all within a single school year. Now multiply that times one hundred. That starts to detail the level of complexity we have to manage.

I’m the sole IT person for our Agency of 170 users and 150 computers spread across seven main sites and 15 schools. So my time to manage user access is pretty slim. It would be nice to have another person to manage EMR stuff but our Agency just doesn’t have that kind of money. Being a non-profit has some limitations.  :slight_smile:

I’ll keep poking at OEMR because I think it is the most flexible solution we have. As opposed to:
* www.ssimed.com - EMRge
* www.medicalofficeonline.com - Medical Office Online
* etc etc etc

While those systems are good solutions I don’t believe they’d be able to tailor themselves to our needs without some steep costs.

Jason

sunsetsystems wrote on Thursday, December 27, 2007:

I can understand why you’d want to have just one database, but due to HIPAA privacy requirements the normal thing to do is set up one OpenEMR instance (with its own database) per clinic.

The missing part would be a component to transfer patient records from one installation to another, in the case where the patient has given permission to do that.  This would be a nice addition to OpenEMR if you or someone else is willing to sponsor the work.

Rod
www.sunsetsystems.com

drbowen wrote on Friday, December 28, 2007:

HIPPA does not require this if these are a single legal entity.  Most commonly, medical clinics are separate legal entities but large Public Health / Mental Health organizations are usually one legal entity.  In mental health the "need to know" constraints are more tighter than the typical privately owned medical clinic.  (One would not want secretaries and clinicians knowing about patients with whom they are not clinically involved).

Hospital owned and Publicly owned operations have different legal constraints.  They can refer between clinics without difficulty.  Physician owned practices have to worry about Stark Law issues.